Active NPI
Jude Powell
- Clinical Social Worker
- Roswell, GA
National Provider Identifier
1558112557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1462 Raintree Dr Apt M
Roswell, GA 30076-6706 - Phone
- (470) 788-9166
- NPI assigned
- Mar 28, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
1462 Raintree Dr Apt M
Roswell, GA 30076-6706
Mailing address
1910 Hazelwood Dr SE
Marietta, GA 30067-7212
Phone (470) 788-9166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711756800000",
"number": "1558112557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 HAZELWOOD DR SE",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300677212",
"telephone_number": "470-788-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1462 RAINTREE DR APT M",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300766706",
"telephone_number": "470-788-9166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "JUDE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-28",
"last_updated": "2024-03-30",
"certification_date": "2024-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.